Individual
LISA LEDLOW KUNTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
52 MEDICAL PARK DRIVE EAST, STE 307, BIRMINGHAM, AL 35235
(205) 838-3047
(205) 838-3497
Mailing address
52 MEDICAL PARK DRIVE EAST, STE 307, BIRMINGHAM, AL 35235
(205) 838-3047
(205) 838-3497
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
KUNI04291580
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051500128
BCBS OF AL
AL
01
—
051517707
BCBS OF ALABAMA
AL
05
—
051552793
—
AL
01
—
1982710299
NPI
AL
01
—
63-0620636
TAX ID
AL
Enumeration date
08/21/2006
Last updated
04/21/2010
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